Medication·Interactions & depletion·Reviewed June 9, 2026
Tacrolimus interactions.
Tacrolimus has 5 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Magnesium. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Tacrolimus at a glance.
A quick, data-grounded summary. The full tables are below.
Tacrolimus has 5 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Magnesium. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with tacrolimus.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| St. John's Wort | Contraindicated | St. John's Wort can markedly lower tacrolimus concentrations and cause rejection risk. |
| Berberine | Caution | Berberine may alter CYP3A or P-glycoprotein activity and make tacrolimus concentrations unpredictable. |
| Potassium | Caution | Tacrolimus can cause hyperkalemia, and potassium supplements or salt substitutes can make levels dangerous. |
| Quercetin | Caution | Quercetin may inhibit CYP3A4 or P-glycoprotein and could increase tacrolimus exposure and toxicity. |
| Magnesium Glycinate | Synergy | Magnesium can help correct tacrolimus-associated hypomagnesemia when monitored. |
What tacrolimus can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Magnesium | Significant | Tacrolimus can cause renal magnesium wasting and clinically significant hypomagnesemia. | Magnesium Glycinate | Serum magnesium |
The full tacrolimus profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common tacrolimus questions.
Quick answers drawn from the tables above.
What interacts with Tacrolimus?
In the NutriStack database, Tacrolimus has 5 documented interactions. The most notable include St. John's Wort, Berberine, Potassium, Quercetin, and Magnesium Glycinate. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Tacrolimus?
Tacrolimus is flagged against 1 substance in the database, including St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Tacrolimus deplete any nutrients?
Tacrolimus is associated with lowering Magnesium with prolonged use. Useful biomarkers to monitor include Serum magnesium. Ask your prescriber before adding any replacement supplement.
Is it safe to take St. John's Wort with Tacrolimus?
NutriStack classifies the St. John's Wort and Tacrolimus pairing as contraindicated: St. John's Wort can markedly lower tacrolimus concentrations and cause rejection risk. Avoid completely unless the transplant team explicitly directs otherwise. Always confirm with your prescriber.
Check your whole stack
See how tacrolimus fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.